This invention provides a method for dealing with problems of infertility and of a tubal or ectopic pregnancy. In one treatment for infertility, biological material such as gametes and zygotes are deposited into the fallopian tube. Unfortunately, it is difficult to gain access to the fallopian tubes in order to make this deposition.
Generally, there are two approaches for gaining access to a fallopian tube. One is the laparoscopic approach to a distal region of the fallopian tube. The second and preferred approach which is less invasive is placing of a catheter transcervically into the fallopian tube. This requires passing of the catheter through the cervix, uterus and ostium of the fallopian tube and then navigating the fallopian tube an appropriate distance. One problem with this approach is getting the catheter to pass from the uterus through the ostium into the fallopian tube.
Various techniques have been employed in an effort to gain access to the fallopian tube from the uterus. One approach is to use tactile feel, but this requires a high amount of dexterity for the clinician and there is no assurance that the catheter has been placed within the fallopian tube. For ectopic therapy, tactile feel will not locate the ectopic in the fallopian tube. The catheter can be guided ultrasonically, but this involves additional discomfort to the patient and also does not provide a high level of assurance that the fallopian tube has been accessed.
Hysteroscopic guidance may also be used but this requires insufflation of the uterus which can have a negative effect on the placement of biological material and involves additional discomfort to the patient when employed on an outpatient basis. It is also known to utilize an everting catheter to gain access to the fallopian tubes and to guide an instrument such as an endoscope into the fallopian tube, but so far as we are aware, everting catheters have not been used to deposit biological material or to eliminate ectopic pregnancies.
The catheters used previously for the deposition of biological material were single lumen catheters constructed of polytetrafluoroethylene. These catheters were inserted into the fallopian tube using tactile feel, hysteroscopic guidance or ultrasonic guidance and a syringe at the proximal end of the catheter was used to expel the biological material into the fallopian tube. In addition to these three techniques, it is also known to use guidewires for placing the single lumen catheter within the fallopian tube and access to the ostium of the fallopian tube was obtained using a stiffer guiding catheter which directs the single lumen catheter to the ostium.